J Korean Rheum Assoc.  2009 Jun;16(2):144-149. 10.4078/jkra.2009.16.2.144.

A Case of Adult Acute Myeloid Leukemia Presenting with Musculoskeletal Manifestations

• Kim HD
• Hwang JS
• Cho YJ
• Han NM
• Jung KY

• KMID: 2202130
• DOI: http://doi.org/10.4078/jkra.2009.16.2.144

Abstract

Leukemia is a heterogenous group of neoplasms that arise from the malignant transformation of hematopoietic cells. The usual presentation is one of lethargy, pallor, fever, purpura, bleeding, etc, and all this is secondary to a decrease in the production of normal blood components. However, leukemia often manifests with musculoskeletal symptoms without a systemic presentation. Musculoskeletal symptoms that precede the recognition of leukemia are much less frequent in adults as compared to those in children, and this causes diagnostic confusion and a delayed diagnosis. We describe here a case of adult acute myeloid leukemia in which pain and weakness of the limbs were the main manifestations and these were suspected as being symptoms of musculoskeletal disease.

Keyword

Leukemia; Musculoskeletal manifestations

MeSH Terms

Adult
Child
Delayed Diagnosis
Extremities
Fever
Hemorrhage
Humans
Lethargy
Leukemia
Leukemia, Myeloid, Acute
Musculoskeletal Diseases
Pallor
Purpura

Figure

• 

  Fig. 1. Coronal T1-weighted spin-echo image of the metaphysis and diaphysis of the right humerus shows a diffuse low signal intensity due to marrow infiltration (A) and (B) the corresponding fat-suppressed T2-weighted image shows multiple areas with a high signal intensity.

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  Fig. 2. Whole body bone scan with Tc-99m HDP shows hot uptake of both proximal humeri, femurs, and the left tibia.

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  Fig. 3. Bone marrow aspirate findings (Wright-Giemsa stain, ×1,000). Leukemic cells reveal large-sized, coarse nuclear chromatin with distinct nucleoli and scant basophilic cytoplasm.

Reference

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